Luke Barbara, Brown Morton B, Hediger Mary L, Misiunas Ruta B, Anderson Elaine
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida 33143, USA.
Twin Res Hum Genet. 2006 Feb;9(1):81-8. doi: 10.1375/183242706776403064.
The purpose of this prospective cohort study of twins and triplets was to evaluate perinatal and early childhood outcomes through 18 months of age. The study population included 141 twin pregnancies (282 twin children) and 8 triplet pregnancies (24 triplet children) recruited between May, 1996 and June, 2001. Mothers of triplets versus twins were significantly more likely to have infertility treatments, to be overweight or obese before conception, to be admitted antenatally, and to deliver by cesarean section. Length of gestation for triplets was significantly shorter (-2.31 weeks, p < .0001), and more likely to be less than 35 weeks (Adjusted Odds Ratio [AOR] 9.38, 95% confidence interval [CI] 3.22-27.29). Average birthweight for triplets was significantly lighter (-495 grams, p < .0001), and more likely to be low birthweight (AOR 11.38, 95% CI 3.11-41.61). Triplets were also more likely to be admitted to neonatal intensive care (AOR 7.97, 95% CI 2.13-29.77), to require mechanical ventilation (AOR 5.67, 95% CI 2.05-15.65), to develop respiratory distress syndrome (AOR 12.50, 95% CI 3.89-40.20), or a major morbidity (retinopathy of prematurity, necrotizing enterocolitis, ventilator support, or grade III or IV intraventricular hemorrhage, AOR 5.67, 95% CI 2.05-15.65). Weight, length, and head circumference was significantly smaller at birth for triplets compared to twins, and these differences remained through 18 months of age, along with lower mental developmental scores at the oldest age. Compared to twins, triplets have greater neonatal morbidity, and through 18 months of age lower mental and motor scores, slower postnatal growth and more residual stunting, particularly of length and head circumference.
这项针对双胞胎和三胞胎的前瞻性队列研究的目的是评估18个月龄以内的围产期和幼儿期结局。研究人群包括1996年5月至2001年6月招募的141例双胎妊娠（282名双胎儿童）和8例三胎妊娠（24名三胎儿童）。与双胞胎母亲相比，三胞胎母亲更有可能接受不孕治疗，受孕前超重或肥胖，产前入院，并通过剖宫产分娩。三胞胎的妊娠期明显更短（-2.31周，p < .0001），且更有可能少于35周（调整后的优势比[AOR] 9.38，95%置信区间[CI] 3.22 - 27.29）。三胞胎的平均出生体重明显更轻（-495克，p < .0001），且更有可能为低出生体重（AOR 11.38，95% CI 3.11 - 41.61）。三胞胎也更有可能入住新生儿重症监护病房（AOR 7.97，95% CI 2.13 - 29.77），需要机械通气（AOR 5.67，95% CI 2.05 - 15.65），发生呼吸窘迫综合征（AOR 12.50，95% CI 3.89 - 40.20），或发生严重疾病（早产儿视网膜病变、坏死性小肠结肠炎、呼吸机支持或III级或IV级脑室内出血，AOR 5.67，95% CI 2.05 - 15.65）。与双胞胎相比，三胞胎出生时的体重、身长和头围明显更小，这些差异在18个月龄时仍然存在，同时在最大年龄时智力发育得分更低。与双胞胎相比，三胞胎有更高的新生儿发病率，在18个月龄时智力和运动得分更低，出生后生长较慢，且有更多的生长迟缓残留，尤其是身长和头围方面。
